Ulrich J Spiegl1, Georg Osterhoff2, Philipp Bula3, Frank Hartmann4, Max J Scheyerer5, Klaus J Schnake6, Bernhard W Ullrich7. 1. Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany. uli.spiegl@gmx.de. 2. Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany. 3. Department of Orthopaedics and Trauma Surgery, Klinikum Gütersloh, Gütersloh, Germany. 4. Center for Trauma and Orthopedic Surgery, Gemeinschaftsklinikum Mittelrhein, Ev. Stift, Koblenz, Germany. 5. Department of Orthopedics and Trauma Surgery, University Hospital of Cologne, Cologne, Germany. 6. Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus, St. Marien, Erlangen, Germany. 7. Department of Trauma Surgery and Reconstructive Surgery, BG Klinikum Bergmannstrost, Halle, Germany.
Abstract
PURPOSE: The aim of this study was to give a systematic overview over the rate and location of concomitant injuries, the probability of suffering from neurological deficits, and to give evidence of the timing of surgery in severely injured patients with unstable thoracic vertebral body fractures. METHODS: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to November 2020 dealing with unstable fractures of the mid-thoracic spine. RESULTS: Altogether, 1109 articles were retrieved from the literature search. A total of 1095 articles were excluded. Thus, 16 remaining original articles were included in this systematic review depicting the topics timing of surgery in polytraumatized patients, outcome neurologic deficits, and impact of concomitant injuries. The overall level of evidence of the vast majority of studies is low. CONCLUSION: The evidence of the available literature is low. The cited studies reveal that thoracic spinal fractures are associated with a high number of neurological deficits and concomitant injuries, particularly of the thoracic cage and the lung. Thereby, diagnostic algorithm should include computer tomography of the whole thoracic cage if there is any clinical sign of concomitant injuries. Patients with incomplete neurologic deficits benefit from early surgery consisting of decompression and long-segmental stabilization.
PURPOSE: The aim of this study was to give a systematic overview over the rate and location of concomitant injuries, the probability of suffering from neurological deficits, and to give evidence of the timing of surgery in severely injured patients with unstable thoracic vertebral body fractures. METHODS: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to November 2020 dealing with unstable fractures of the mid-thoracic spine. RESULTS: Altogether, 1109 articles were retrieved from the literature search. A total of 1095 articles were excluded. Thus, 16 remaining original articles were included in this systematic review depicting the topics timing of surgery in polytraumatized patients, outcome neurologic deficits, and impact of concomitant injuries. The overall level of evidence of the vast majority of studies is low. CONCLUSION: The evidence of the available literature is low. The cited studies reveal that thoracic spinal fractures are associated with a high number of neurological deficits and concomitant injuries, particularly of the thoracic cage and the lung. Thereby, diagnostic algorithm should include computer tomography of the whole thoracic cage if there is any clinical sign of concomitant injuries. Patients with incomplete neurologic deficits benefit from early surgery consisting of decompression and long-segmental stabilization.
Authors: Sebastian Krinner; Sina Grupp; Pascal Oppel; Andreas Langenbach; Friedrich F Hennig; Stefan Schulz-Drost Journal: J Thorac Dis Date: 2017-04 Impact factor: 2.895
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Authors: M Reinhold; C Knop; R Beisse; L Audigé; F Kandziora; A Pizanis; R Pranzl; E Gercek; M Schultheiss; A Weckbach; V Bühren; M Blauth Journal: Unfallchirurg Date: 2009-01 Impact factor: 1.000
Authors: Markus R Konieczny; Johannes Strüwer; Birger Jettkant; Christian Schinkel; Thomas Kälicke; Gert Muhr; Thomas M Frangen Journal: Spine J Date: 2013-10-17 Impact factor: 4.166
Authors: Max J Scheyerer; Stefan M Zimmermann; Samy Bouaicha; Hans-Peter Simmen; Guido A Wanner; Clément M L Werner Journal: Emerg Med Int Date: 2013-11-13 Impact factor: 1.112